Intelligent Insulin vs. Artificial Intelligence for Type 1 Diabetes: Will the Real Winner Please Stand Up?

Research in the treatment of type 1 diabetes has been addressed into two main areas: the development of "intelligent insulins" capable of auto-regulating their own levels according to glucose concentrations, or the exploitation of artificial intelligence (AI) and its learning capacity, to provide decision support systems to improve automated insulin therapy. This review aims to provide a synthetic overview of the current state of these two research areas, providing an outline of the latest development in the search for "intelligent insulins," and the results of new and promising advances in the use of artificial intelligence to regulate automated insulin infusion and glucose control. The future of insulin treatment in type 1 diabetes appears promising with AI, with research nearly reaching the possibility of finally having a "closed-loop" artificial pancreas.

Association of FTO polymorphisms with early age of obesity in obese Italian subjects.

Obesity is recognized as a major health problem worldwide. Genetic factors play a major role in obesity, and genomewide association studies have provided evidence that several common variants within the fat mass- and obesity-associated (FTO) gene are significantly associated with obesity. Very limited data is available on FTO in the Italian population.

The 148M allele of the PNPLA3 gene is associated with indices of liver damage early in life.

Background & Aims: Childhood obesity is a growing problem worldwide. Non-alcoholic fatty liver disease (NAFLD) is frequently associated with obesity in children. Recently, the PNPLA3 gene I148M (rs738409) variant was demonstrated to be strongly associated with hepatic steatosis in obese adults.

Prevalence of type 1 diabetes autoantibodies (GADA, IA2, and IAA) in overweight and obese children.

Objective: Little is known about the prevalence of beta-cell autoantibodies in children with excess body weight. The prevalence of type 1 diabetes autoantibodies and its relation with hyperglycemia was analyzed in 686 overweight/obese children and adolescents.

Research Design And Methods: All children underwent an oral glucose tolerance test, and anti-GAD, anti-IA2, and anti-IAA autoantibodies were measured.

Characterization of thyroglobulin epitopes in Sardinian adults and juveniles with Hashimoto's thyroiditis: evidence against a major effect of age and genetic background on B-cell epitopes.

Background: Using recombinant human monoclonal thyroglobulin antibodies expressed as Fab molecules (TgAb-Fab), we have recently confirmed the restriction of Tg epitopes in Hashimoto's thyroiditis (HT).

Objective: To investigate Tg epitopes of serum TgAb in HT adults and HT juveniles from a geographically isolated area (Sardinia).

Design And Patients: Serum TgAb of 39 Sardinian HT adults, 53 Sardinian HT juveniles and 45 non-Sardinian HT adults were evaluated.

Puberty is associated with a marked increase of the female sex predominance in chronic autoimmune thyroiditis.

Background: Chronic autoimmune thyroiditis (CAT) displays a strong female predominance with female-to-male (F:M) ratios of 4-20:1 in adults and 2-9:1 in children and adolescents. Both genetic and hormonal factors are involved in this phenomenon. The relation between puberty and F:M ratio in CAT has never been evaluated.

Oral glucose tolerance test in Italian overweight/obese children and adolescents results in a very high prevalence of impaired fasting glycaemia, but not of diabetes.

Background: Very few studies on glucose abnormalities in European overweight/obese children and adolescents are available, and scientific evidence on the value of standard oral glucose tolerance test (OGTT) in childhood is lacking. We therefore aimed to establish prevalence and features of impaired fasting glucose (IFG), impaired glucose tolerance (IGT) and type 2 diabetes (T2D) in a large cohort of Italian overweight/obese children and adolescents and to assess the validity of standard OGTT in the paediatric population.

Methods: This is a 1-year observational study conducted on 736 (535 overweight/obese and 201 normal weight) consecutive paediatric patients attending the outpatient clinic of Paediatric Endocrine Unit.

Identification of sequence variants in the UBL5 (ubiquitin-like 5 or BEACON) gene in obese children by PCR-SSCP: no evidence for association with obesity.

Background: Childhood obesity has a strong genetic background. The human UBL5 (BEACON) gene has been suggested as a candidate gene for obesity. Previous studies in populations of different ethnicities have shown a significant association between UBL5 variants and measures of body fatness.

Assessment of adiponectin and leptin as biomarkers of positive metabolic outcomes after lifestyle intervention in overweight and obese children.

Background: A number of metabolic changes are caused by childhood obesity, including insulin resistance, diabetes, and dyslipidemia. To counteract them, lifestyle modification with changes in dietary habits and physical activity is the primary intervention. Anthropometric parameters may not identify all positive changes associated with lifestyle modifications, whereas circulating adipokines may represent an alternative as biomarkers.

Cardiovascular risk in elderly hypothyroid patients.

Overt hypothyroidism (OH) and subclinical hypothyroidism (SH) are frequently found in the elderly. OH is associated with several functional cardiovascular abnormalities and increased risk of atherosclerosis resulting from hypertension associated to atherogenic lipid profile. Other potential atherogenic factors involved in OH are increased circulating C-reactive protein and homocysteine, increased arterial stiffness, endothelial dysfunction, and altered coagulation parameters.

Cardiac effects of L-thyroxine administration in borderline hypothyroidism.

Objective: To investigate the clinical relevance of l-thyroxine (l-T(4)) substitution therapy in borderline hypothyroidism.

Design: To assess whether and to what extent administration of l-T(4) is able to modify systolic and diastolic function in patients with subclinical hypothyroidism and in subjects with autoimmune thyroiditis and normal serum TSH.

Methods: We studied 26 patients with classical Hashimoto's thyroiditis [18 with increased serum TSH (>3 mU/ml - Group A), and 8 with normal serum TSH (<3 mU/ml) - Group B]; a third group (C) included 13 healthy controls.